Today, notwithstanding very significant advances in many sectors of the health-care industry, the inability to quickly identify patients accurately and durably continues to result in numerous incidents which, one would think, should be avoidable. Consequences may include medication error, transfusion errors, medication errors, mistaken phlebotomies, surgery errors, financial and other issues, testing errors, wrong person procedures, and the discharge of infants to the wrong families. Numerous incidents are reported every year with patient misidentification cited in individual root cause analyses, such as that conducted by the United States Department of Veterans Affairs (VA) National Center for Patient Safety. Nevertheless, despite availability of numerous products and strategies designed to reduce the risk of patient misidentification and the consequences of such incidents, the problem persists.
Current methodology for the identification of patients at medical facilities generally involves the use of a wrist bracelet. Problems with current band methods of identification include interference with intravenous insertion, in the need to remove during certain procedures situations, the fact that such bands are uncomfortable, and the possibility of their presenting a hazard. Such bands also carry limited information, sometimes making necessary additional devices.
Moreover, continuing pressures to limit hospital staff working hours increases the risk of such errors, due to the increased number of staff nurses, technicians, residents and other doctors caring for each patient. Thus, increased hand-over and other communication risks are increased as current medical care strategies evolve. Also significant is the likelihood that changes in medicine due to the implementation of the affordable care act and increasing political involvement in the medical system will create pressures that will increase the likelihood of misidentification incidents.
Given the longstanding high profile recognition that patient misidentification is a serious problem, numerous solutions have been proposed, including barcoding, color coding of patient wristbands, use of multiple identification strategies, and venous pattern recognition systems. Many of these solutions seek to improve patient care by including additional information at the point of care. More recent suggestions involve the use of RFID technology.
Likewise, numerous tagging technologies have long been available, diversely ranging from approaches as simple as the number on a ball player's jersey to technologies as sophisticated RFID tagging, and including such things as rubber stamp applied ink markings on the wrists of concertgoers, bracelets and nametags for convention attendees, branding of cattle, temporary cutaneous identification device (so-called temporary tattoos) warning of allergies and printed adhesive tags for visitors to buildings with a name, a picture and the identification of an organization being visited.
However, despite the availability of such a wide range of tagging and identification systems, despite their drawbacks and limitations, simple alphanumeric patient identification wristbands remain the only significant method employed for identification of patients. Other tagging and identification systems face significant obstacles to implementation in the context of a multi-patient medical facility. Color coding of patient wristbands is of limited value, given the relatively limited palette available. Color coding has also not been adopted due to a relatively high likelihood of causing misinformation to be perceived by medical care staff. Barcoding schemes require significant and expensive hardware at the point of care. Moreover, in critical situations, delays caused by the absence of immediate availability of barcode reading equipment can result in unacceptable delay. Even after barcode reading equipment has been accessed, system delays may delay access to information. Likewise, other methodologies such as RFID, and use of the veins of the patient on a part of the body such as the back of the hand as a fingerprint-type identifier, also involve delays while appropriate equipment is accessed and while that equipment accesses data.
Current RFID, barcode and physiology pattern recognition systems can also suffer from relatively large startup costs, and yield little information or no information beyond identification. This combined with the fact that various types of accessibility/system failures may introduce new errors, such systems have not seen widespread adoption. Thus, despite all their problems, as noted above, and even the potential of providing a choking hazard to newborns, nevertheless, patient wristbands including only a minimal amount of information remain, by an overwhelming majority, the dominant patient identification system currently in use.